Reduction
of Risk Behaviors in Youth including:
Adolescent Sexuality
Karen Hoffman
Introduction
The study of adolescent sexuality has been divided into two important areas:
the development of healthy sexuality in adolescence and the risks that are
associated with too early or unsafe sexual activity. Frequently we forget
that adolescence is a time where experimentation with sexuality is normal
and there are safe and developmentally appropriate ways in which this may
occur. To date researchers have primarily focused on the possible negative
effects that occur at developmentally inappropriate times or in unsafe ways.
The primary risks for adolescents include teenage pregnancy and sexually
transmitted infections, including HIV. In order to use sexuality research
in a way that is most beneficial to youth, both the factors that contribute
to the promotion of healthy sexual development as well as those factors
that lead to a reduction of risky sexual behavior should be examined.
During adolescence it is essential that individuals form a sexual identity
and a sense of sexual well-being. These processes determine adolescents'
comfort with their own emerging sexuality as well as that of others. It
is important for adolescents to become comfortable with their own changing
bodies, learn to make good decisions about what, if any, sexual activities
they wish to engage in, and how to be safe in the process (Brooks-Gunn
& Paikoff, 1997). Adolescents also are beginning to become involved in
intimate relationships, which is a context where sexual activity often
occurs.
Engaging in "safer" sexual activity, has been linked to psychosocial maturity
and sexual well-being (Brooks-Gunn & Paikoff, 1997). Developing a healthy
sense of one's own sexuality, and learning to express it in a safe and
mature manner is one of the most frequently ignored aspects of adolescent
development. While there are potential benefits of engaging in safer sexual
activity in adolescence, the serious nature of the possible negative outcomes
has led to a body of literature that examines sexual activity as a risk
behavior to be avoided (White & White, 1991; Department of Health and
Human Services, 1990). This has developed in part because many adolescents
do not use condoms during their early experiences with intercourse and
teenagers often have multiple sexual partners. The Centers for Disease
Control (1991) estimate that approximately 8 million of the approximately
12 million reported cases of sexually transmitted infections occur in
individuals under 25 years of age. This can be particularly tragic because
it is those same behaviors which place an adolescent at risk for other
STIs that also place them at risk for HIV and eventually AIDS.
Teenage pregnancy also is a major problem in the United States today.
Over one million teenage girls become pregnant each year resulting in
a number of social and economic problems for which society often pays
the price. Almost 20% of females will become pregnant before the age of
20 and approximately half of these will result in live births (Zabin &
Haywood, 1993). These children of adolescent parents are often disadvantaged
in many areas. They are at greater risk of being born premature, possibly
because of improper nutrition and prenatal care. Their mothers are often
educationally and economically disadvantaged and there is a greater likelihood
of being raised in an unstable or single parent household (Voydanoff &
Donnelly, 1990). Public interest in helping adolescents to avoid these
possible pitfalls accounts for many of the recent programs targeting the
modification of adolescent sexual behavior.
Measuring actual sexual behavior is often considered the most effective
way of judging the effectiveness of intervention programs. Actual behaviors
that are frequently tested are the absence or presence and frequency of
sexual activity and contraceptive use, particularly condom use. Other
factors such as knowledge about sexuality, decision-making skills and
perceived peer sexual involvement, have been linked to either abstinence
or safer sexual behavior, it is these more distal components that are
often targeted as domains for intervention. Some of the possible related
elements that could be targeted as domains for intervention are listed
below.
Related Elements
Possible domains for intervention include these factors which are
associated with safer sexual activity: |
|
Development of a healthy sense
of sexual well-being, including aspects involving physical, intellectual,
social, and emotional development |
|
Knowledge and attitudes about contraceptives,
specifically condoms |
|
Availability of contraception |
|
Knowledge and attitudes about risks associated
with sexual activity, specifically HIV/AIDS |
|
Personality factors, such as responsibility
and future orientation |
|
Context in which sexual activity occurs and
the amount of communication between partners |
|
Perceptions of peer sexual behavior |
|
Peer knowledge about sex and contraception
|
|
Parental communication, values and monitoring |
|
Stressful life events |
|
Locus of control |
|
Dependency needs and perception of social support |
|
Educational performance and expectations |
Summary
In recent years there has been a great deal of discussion regarding the
need for programming which addresses many of these issues associated with
adolescent sexuality. Unfortunately not enough time has been spent in
developing programs that will help adolescents to develop a healthy sense
of their own sexuality (Donavon, 1998). However there have been many programs
designed to eliminate the negative outcomes that may result from adolescent
sexual activity (White & White,1991; Department of Health and Human Services,
1990). The Extension Adolescent Sexuality Position statement recommends
the following guidelines when developing and implementing programs on
adolescent sexuality.
1. Sexuality education is an integral part of positive youth development
education, an area in which Extension has historically demonstrated ability
and strength.
2. Adolescents should have access to information that supports healthy
sexual development.
3. Sexuality education should be based on the values of honesty, respect
for diverse values and experiences, and responsibility.
4. Sexuality develops in an ecological context and requires an holistic
approach which includes the self, family, peers, communities, schools
and media. Our efforts should especially acknowledge and support the central
role of the family in sexuality education.
5. Education should be guided by research that is community-based and
culturally appropriate.
6. Programs should include both males and females as educators and participants
(BAPPS).
This statement also advocates that Extension professionals consider issues
of adolescent sexuality to be important areas for programming. The resources
listed below may be helpful for learning about the issues associated with
adolescent sexuality, including topics that relate specifically to programming
and evaluation. These resources include research studies that have found
particular characteristics to be either a risk or protective factor for
adolescent sexual behavior. These predictors of either sexual behavior
or abstinence could be used to guide programming. Programs that help to
produce protective characteristics and reduce risk factors have been found
to be effective in many areas of youth development (Roth, Brooks-Gunn,
Murray & Foster, 1998).
Additionally evaluations of various programs dealing with issues of adolescent
sexuality are included. These evaluations can provide information on those
programs that are currently in existence and have been evaluated. Having
knowledge of which programs have been successful and which have not could
be important when choosing a curriculum. A small section on Internet resources
has also been included. These resources not only offer excellent information
about adolescent sexuality, they also offer numerous links to other web
sites and other types of resources. Finally the last section of this site
will provide information on measures to be used in evaluation. There are
some compilations of measures listed as well as detailed descriptions
of some of the measures that could be used to evaluate programs addressing
adolescent sexuality.
References
Bridge for Adolescent Pregnancy, Parenting
and Sexuality web site http://www.nnh.org/Work%20Groups/teenpreg2.htm
Brooks-Gunn, J. & Paikoff, R. (1997). Sexuality
and Developmental Transitions during Adolescence. In J. Schulenberg, J.L.
Maggs & K. Hurrelman (Eds.) Health risks and developmental trajectories
during adolescence. New York: Cambridge University Press.
Christopher, F.S. & Roosa, M.W. (1990). An evaluation
of an adolescent pregnancy prevention program: Is "just say no" enough?
Family Relations, 39, 68-72.
Department of Health and Human Services. (1990).
Adolescent family life demonstration projects: Program and evaluation
summaries. Washington, DC: Author.
Donovon, P. (1998). School-based sexuality education:
The issues and challenges. Family Planning Perspectives, 30(4), 188-193.
Hayes, C.D. (Ed.)(1987). Risking the Future:
Adolescent Sexuality, Pregnancy and Childbearing, National Academy Press;
Washington DC.
Roth, J., Brooks-Gunn, J., Murray, L. & Foster,
W. (1998). Promoting healthy adolescents: Synthesis of youth development
program evaluations. Journal of Research on Adolescence, 8, 423-459.
Voydanoff, P. & Donnelly, B.W. (1990). Adolescent
Sexuality and Pregnancy. Newbury Park, Ca: Sage Publications.
White, C.P. & White, M.B. (1991) The Adolescent
Family Life Act (AFLA): Content, findings and policy recommendations for
pregnancy prevention programs. Journal of Clinical Child Psychology, 20,
58-70.
|